PEDIATRICS Vol. 56 No. 3 September 1975, pp. 479-483
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kelalis, P.
Right arrow Articles by Lucas, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kelalis, P.
Right arrow Articles by Lucas, A.

The Timing of Elective Surgery on the Genitalia of Male Children With Particular Reference to Undescended Testes and Hypospadias

Panayotis Kelalis M.D., Raymond Bunge M.D., Martin Barkin M.D., Alan D. Perlmutter M.D., David B. Friedman M.D., Henry H. Work M.D., and Alexander Lucas M.D.

Psychologic considerations suggest that the optimal time for elective surgery on the genitalia is either the first 6 months of life or sometime during the fourth year. In the child with cryptorchidism, physiologic considerations are of paramount importance and the timing of treatment should be based on these considerations. Despite the conflicting views on the subject, there is suggestive evidence that early orchiopexy—during the first year of life or soon afterwards—may be the most optimal time for orchiopexy, but further investigation would be necessary to confirm this. Currently, timing of operation is based more on psychologic rather than physiologic factors (although both are taken into account), and should remain unchanged until further evidence accumulates.

The Committee feels that the later the orchiopexy after age 6, the more likely germinal epithelial failure will occur. However, it should be pointed out that 5 or 6 has not proven to represent optimal age in respect to germinal function but only the latest recommended age for orchiopexy.

In patients with hypospadias, technical considerations have the greatest bearing on timing, but, depending on the individual surgeon, the precise timing varies. The period after the third birthday is preferred by the majority; this certainly is consistent with psychologic considerations unless the correction of chordee justifies a separate cedure, which then should be corrected by age 2.




This article has been cited by other articles:


Home page
 J Pediatr PsycholHome page
V. B. Schonbucher, D. M. Weber, and M. A. Landolt
Psychosocial Adjustment, Health-Related Quality of Life, and Psychosexual Development of Boys with Hypospadias: A Systematic Review
J. Pediatr. Psychol., June 1, 2008; 33(5): 520 - 535.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
C. Myrup, T. H. Schnack, J. Wohlfahrt, W. W.M. Hack, K. Sijstermans, L. M. van der Voort-Doedens, A. Pettersson, O. Akre, and L. Richiardi
Correction of Cryptorchidism and Testicular Cancer
N. Engl. J. Med., August 23, 2007; 357(8): 825 - 827.
[Full Text] [PDF]